Mental Health Center

Cutting and Self-Harm: Warning Signs and Treatment

Turning Inward to Heal

Many kids haven't thought about it at all -- exactly why they self-injure, says Lader. "It's like any addiction, if I can take a pill or self-medicate in some way, why deal with the problem? We teach people that cutting only works in the short term, and that it will only get worse and worse."

When kids learn to face their problems, they will quit self-harming, she adds. "Our goal is to get them to communicate what's wrong. Babies don't have the capacity for language, so they use behavior. These adolescents regress to that preverbal state when they self-harm."

Individual and group therapy are the hubs of this treatment program. If there is underlying depression or anxiety, antidepressants may be prescribed. The patients also write regularly in their journals -- to learn to explore and express their feelings.

Helping them gain self-respect and self-esteem is a critical treatment goal, Conterio tells WebMD.

"Many kids have difficulty dealing with situations and people that make them angry," Lader adds. "They don't have great role models for that. Saying no, standing up to people -- they don't really believe they're allowed to do that, especially girls. But if you can't do that, it's very difficult to maneuver the world, survive in the world without someone stronger, more capable than you to fight your battles."

Circular negative thinking keeps kids from developing self-esteem. "We help them empower themselves, take risks in confrontation, change how they view themselves," says Conterio. "If you can't set limits on someone else's behavior, stand up to them -- you can't like yourself. Once these girls learn to take care of themselves, stand up for what they want, they will like themselves better."

"We want them to get to the point where they believe, 'I am somebody, I do have a voice, I can make changes, instead of, 'I'm nobody,'" she says.

Staying Safe

One study of the SAFE program showed that, two years after participating, 75% of patients had a decrease in symptoms of self-injury. An ongoing study is indicating a decrease in hospitalizations and emergency room visits.

"I've been doing this for 20 years, and the success rate is far greater than the failure rate," says Conterio. "We truly believe that if people can continue to make healthy choices, they won't go back to self-harm. We get emails that are a blast from the past. Some patients do extremely well. Others regress. Others have finally decided to do the work they learned here. When they apply it, they do well. It all goes back to choice."

The bottom line: "When kids decide they don't want to cut any more - and they get stressed again -- they have to be able to manage stress as it arises," Rosen says. "They can't succumb to cutting. People who can figure out some alternative way to manage stress will eventually quit it."